NP or PA?? I am so confused???

DaisyRN, ACNP · Aug 14, 2007

hey there,

i would suggest searching for this topic on the forum because there have been many recent discussions involving this very topic. once you read some postings, then you can post specific questions/concerns to the appropriate individuals, etc. for clarification.

good luck!

yellow finch, BSN, RN · Aug 14, 2007

hello, I am a nurse who would love to advance her eduation to the next level. I would like to go to grad school and gain more knowledge and learn to diag and treat. I know that both NP and PA's are mid level practitioners. BUT as a nurse I can't stay in one dept b/c I like to jump around and do it all. I find that NP are specialty focus. What if I do FNP and later like to work in an ER?? Then what do I have to go back two more yrs for school??? OR what if I do want to do Surgery with a doc do I have to have a diff type of NP. I don' t know!
A friend who is a PA tells me that I should go the PA road b/c as a PA you can go to any specialty you are trained in every dept and that NP are not they just focus on their specialty. What do you guys think??? I want to do what is best for me but have no idea what that is. Is it true about the having to go back to school for another specialty focus for NP. PLease anyone . Thanks

Just for clarification, NPs can and do work in any specialty with some exceptions in surgery. I'd really, really enjoy being a first assist, but can't seem to find a program close enough to allow me to join the small ranks of surgical NPs.

In any case, NPs programs may focus on a specialty (Women's Health, Adult, Acute Care, Family, etc...), but it doesn't cordon you in such a way that you can't find an area that you'd like to work in. Heck, I know a former ER RN who earned his FNP, went to work for a cardiovascular group, and is finally, after many years, going to work as a primary care NP.

Your choice. Try to shadow at least one PA and NP just to see if you like either perspective better than the other.

Good luck!

core0 · Aug 15, 2007

Just for clarification, NPs can and do work in any specialty with some exceptions in surgery. I'd really, really enjoy being a first assist, but can't seem to find a program close enough to allow me to join the small ranks of surgical NPs.
In any case, NPs programs may focus on a specialty (Women's Health, Adult, Acute Care, Family, etc...), but it doesn't cordon you in such a way that you can't find an area that you'd like to work in. Heck, I know a former ER RN who earned his FNP, went to work for a cardiovascular group, and is finally, after many years, going to work as a primary care NP.
Your choice. Try to shadow at least one PA and NP just to see if you like either perspective better than the other.
Good luck!

Personal opinion, the days of being able to work outside of the specialty seem to be vanishing. The FNP especially is being forced out of the inpatient realm in favor of the ACNP. There is a fair amount of nursing literature within the last couple of years that seems to be defining the FNP role as primary care. There also seems to be some contention over who will see specialty medicine patients as the ANP and ACNP both seem to be claiming this role.

That being said it is location dependent and the farther you are from a major medical center the more you will be allowed to do with a given certification. Also it varies state to state with Texas currently being the strictest on what defines a nursing domain. It also depends on whether the physician is willing to go to bat for you with the credentialing committee. Although I recently saw a FNP who was a former GI nurse get denied inpatient privileges despite the physician putting up a valiant effort.

I would echo the previous poster. Find out how your market works. There are some places that PAs will find very few jobs, there are some places that NPs will find very few jobs. Then shadow some PAs and NPs and see how things work. Look into the educational model and see what will make you happier. Deciding on any career is a personal choice that deserves a fair amount of thought.

David Carpenter, PA-C